The Do’s and Don’ts of Assisting Consumers on HealthCare.gov

Health Insurance Marketplace® sent this bulletin at 10/24/2024 01:48 PM EDT

agents and brokers - selling in the healthcare dot gov marketplace

How to Assist Consumers on HealthCare.gov

While many agents and brokers choose to use a direct enrollment (DE) or enhanced direct enrollment (EDE) pathway to assist consumers with Marketplace enrollments, you can also assist consumers as they use HealthCare.gov. Unlike the DE and EDE agent/broker pathways, only the consumer creates an account on HealthCare.gov. Through the HealthCare.gov application, you as the agent or broker can provide “side-by-side” assistance and help a consumer directly obtain an eligibility determination, select a qualified health plan, and ultimately complete an application.

Here are some do’s and don’ts for assisting consumers with enrolling in coverage through HealthCare.gov.

Do:

Obtain and document consent from consumers, as well as their review and confirmation of their eligibility application information if you are providing the consumer with enrollment assistance or facilitating the enrollment of that consumer.
Have consumers create their own HealthCare.gov account. The privacy and security agreement agents and brokers enter into with the Centers for Medicare & Medicaid Services (CMS) prohibits an agent or broker from creating a HealthCare.gov account for a consumer.
Ensure you are licensed in each state where you are assisting consumers. Agents and brokers must undergo identity proofing, complete training, and sign applicable agreements with the Marketplace for the applicable benefit year prior to assisting Marketplace consumers.

Don't:

Log in to HealthCare.gov using the consumer’s login credentials. Only consumers may log in to their account and access their HealthCare.gov login credentials. This includes any activities where agents and brokers are logging into or conducting activities on a consumer HealthCare.gov account via screensharing or computer access sharing programs that would allow the AB to access a consumer HealthCare.gov account remotely.
Collect the consumer’s login information. Agents and brokers are not permitted to collect or record a consumer’s login information and are not allowed to have access to a consumer’s HealthCare.gov account.

Have Questions? Contact the Agent/Broker Email Help Desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov.

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